Sexually Transmitted Diseases

Introduction

You're off travelling the world, relaxed without the pressure of having to go to work or school every day, fit and tanned from all the hiking, not to mention lugging around your 70 litre backpack, you've never looked or felt better. At the hostel you meet a good looking Aussie hunk or petite and sexy Swedish miss, out for a few drinks and one thing leads to another...

Whether it's backpackers in the dorm, drunk sales executives at an out-of-town conference or the sex tourists in Thailand, being away from home and responsibilities leads to opportunities to engage with a partner in the sexual congress. There are dangers, though, with sexual activity to catch a sexual transmitted disease.

According to the CDC, there are more than 25 infectious organisms transmitted through sexual activity, and STDs can often result in serious long-term complications, including pelvic inflammatory disease, infertility, stillbirths and neonatal infections, genital cancers, and an increased risk for HIV acquisition and transmission.[1]

Prevention

Abstinence

The best way not to catch an STD is not to have sexual activity with a partner.

Condoms

For persons whose sexual behaviors place them at risk for STDs, correct and consistent use of the male latex* condom can reduce the risk of HIV infection and STD transmission during sexual contact. Only water-based lubricants (e.g., K-Y Jelly or glycerine) should be used with latex* condoms, because oil-based lubricants (e.g., petroleum jelly, shortening, mineral oil, or massage oils) can weaken latex condoms. Vaginal spermicides containing nonoxynol-9 are not recommended in STD/HIV prevention.

Approximately 1-6% of the population exhibits an allergic reaction/sensitivity to latex, which manifests itself as a skin rash (contact dermatitis). Polyurethane condoms are available and can be used as a replacement for latex condoms. Their effectiveness is equal to that of latex. The same oil-based lubricant restrictions apply. Neither lambskin nor any other "natural" condom should be used during sexual activity. These types of protection are designed only for the prevention of pregnancy and will not protect against STDs. Natural condoms are manufactured from animal tissue which allows bacteria/viruses to pass through the membrane.[2][3]

Condom use is not completely protective against the acquisition of an STI because of the presence of pathogens outside the protected skin or from condom breakage. Condoms do not offer complete protection against herpes and genital warts, which are commonly found outside the areas covered by condoms.

Vaccines

Preexposure vaccination is an effective method for prevention of sexually acquired Hepatitis A and Hepatitis B infections. Hepatitis A vaccine is recommended for all unvaccinated persons using injection drugs and MSM. Hepatitis B vaccine is recommended for all unvaccinated persons with a history of STD, multiple sexual partners, use of injection drugs or partner who uses them, or MSM.

Two vaccines (Gardasil™ and Cervarix™) were approved by the FDA in 2006 and 2007, respectively, and are currently available for vaccination against 2 (Cervarix™) and 4 (Gardasil™) of the ~40 existing human papillomaviruses. (At present, there are 15 HPVs associated with genital cancers.) To date, these vaccines have been approved and/or licensed in over 80 countries. The majority of human papillomaviruses run their course and resolve themselves. These vaccines target the four viruses most associated with cervical and other forms of genital cancers

*It must be noted that currently, there is controversy pertaining to the safety of Gardasil™ and Cervarix™ may soon be included. For more information about this controversy, please see the following articles: